The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

“Digital Diagnostics and Communication (DDC) system” Redesigning the Emergency Ambulance

During the development of a new treatment space for the UK emergency ambulance participatory observations with front-line clinicians revealed the need for an integrated patient monitoring, communication and navigation system. The research identified the different information touch-points and requirements through modes of use analysis, day-in-the-life study and simulation workshops with clinicians. Emergency scenario and role-play with paramedics identified 5 distinct ambulance modes of use. Information flow diagrams were created and checked by paramedics and digital User Interface (UI) wireframes were developed and evaluated by clinicians during clinical evaluations. Feedback from clinicians defined UI design specification further leading to a final design proposal. This research was a further development from the 2007 EPSRC funded “Smart Pods” project. The resulting interactive prototype was co-designed in collaboration with ambulance crews and provides a vision of what could be achieved by integrating well-proven IT technologies and protocols into a package relevant in the emergency medicine field. The system has been reviewed by over 40 ambulance crews and is part of a newly co-designed ambulance treatment space.

Schwermineral-Untersuchungen in quartär-zeitlichen Sanden nordwestlich von Hannover

A total of 117 samples of quarternary sediments, mostly sands, from a region NW of Hannover (Lower Saxony) has been investigated with regard to their content of heavy minerals. The absolute percentage of transparent heavy minerals approximates 0.2 Vol.%. If several samples of glaciofluvial sands (Drenthe-stage) or dune sands (Late Weichsel-stage to Holocene) are taken from one outcrop they show great similarities in their heavy minerals contents. Glaciofluvial sands of the Elster-stage evidently have less Garnet, Hornblende and minerals of volcanic origin (Augite, partly also Orthopyroxenes, Oxyhornblende and Olivine) than those of the Drenthe-stage, Weichsel-stage, and the Holocene. All these groups hold nearly the same average assemblages of heavy mineral, thus indicating that within the Drenthe-stage or later material from north and from south has been mixed and/or reworked. In the area investigated the proportions of heavy minerals do not help to identify either the stratigraphic position or the way of deposition of different sandy sediments younger than the Elster-stage. The distributional pattern of several heavy minerals point out that Kyanite, Hornblende and Epidote have been transported predominantly from the north, whereas Garnet and Staurolite have sources both in the north and the south. Tourmaline, Apatite and the minerals of volcanic origin mainly must be derived from the south. All results obtained in the region examined should not be transferred to other zones of the lowlands of Northern Germany automatically.

Off-diagonal ekpyrotic scenarios and equivalence of modified, massive and/or Einstein gravity

Using our anholonomic frame deformation method, we show how generic off-diagonal cosmological solutions depending, in general, on all spacetime coordinates and undergoing a phase of ultra-slow contraction can be constructed in massive gravity. In this paper, there are found and studied new classes of locally anisotropic and (in)homogeneous cosmological metrics with open and closed spatial geometries. The late time acceleration is present due to effective cosmological terms induced by nonlinear off-diagonal interactions and graviton mass. The off-diagonal cosmological metrics and related Stückelberg fields are constructed in explicit form up to nonholonomic frame transforms of the Friedmann–Lamaître–Robertson–Walker (FLRW) coordinates. We show that the solutions include matter, graviton mass and other effective sources modeling nonlinear gravitational and matter fields interactions in modified and/or massive gravity, with polarization of physical constants and deformations of metrics, which may explain certain dark energy and dark matter effects. There are stated and analyzed the conditions when such configurations mimic interesting solutions in general relativity and modifications and recast the general Painlevé–Gullstrand and FLRW metrics. Finally, we elaborate on a reconstruction procedure for a subclass of off-diagonal cosmological solutions which describe cyclic and ekpyrotic universes, with an emphasis on open issues and observable signatures.

Der "Dropstein-Laminit" von Bögerhof und seine Zuordnung zu den Drenthe-zeitlichen Ablagerungen des Wesertals bei Rinteln

Die vorliegende Untersuchung befaßt sich mit eiszeitlichen Ablagerungen im Raum der TK Rinteln. Ein "Ton"-Vorkommen wurde als drenthezeitlicher Dropstein- Laminit angesprochen. Dieser liegt stratigraphisch unter den Krankenhagen-Möllenbecker-Kieskörpern und wurde als geringfügig jünger als der Hauptvorstoß der Drenthe-Vereisung in diesem Raum eingestuft. Für die oben erwähnten Kieskörper wurde eine Entstehung als Endmoränen ausgeschlossen. Sie wurden als Kame-Terrassen gedeutet.

The renormalization group via statistical inference

In physics, one attempts to infer the rules governing a system given only the results of imperfect measurements. Hence, microscopic theories may be effectively indistinguishable experimentally. We develop an operationally motivated procedure to identify the corresponding equivalence classes of states, and argue that the renormalization group (RG) arises from the inherent ambiguities associated with the classes: one encounters flow parameters as, e.g., a regulator, a scale, or a measure of precision, which specify representatives in a given equivalence class. This provides a unifying framework and reveals the role played by information in renormalization. We validate this idea by showing that it justifies the use of low-momenta n-point functions as statistically relevant observables around a Gaussian hypothesis. These results enable the calculation of distinguishability in quantum field theory. Our methods also provide a way to extend renormalization techniques to effective models which are not based on the usual quantum-field formalism, and elucidates the relationships between various type of RG.

BRS 358: Cultivar de arroz irrigado para culinária Japonesa.

2016

Medición de la cultura de seguridad del paciente en un hospital público de primer nivel en el municipio de Villeta

Esta investigación midió la percepción del personal asistencial sobre la cultura de seguridad de los pacientes en un hospital de primer nivel de complejidad por medio de un estudio descriptivo de corte transversal. Se utilizó como herramienta de medición la encuesta ‘Hospital Survey on Patient Safety Cultura’ (HSOPSC) de la Agency of Healthcare Research and Quality (AHRQ) versión en español, la cual evalúa doce dimensiones. Los resultados mostraron fortalezas como el aprendizaje organizacional, las mejoras continuas y el apoyo de los administradores para la seguridad del paciente. Las dimensiones clasificadas como oportunidades de mejora fueron la cultura no punitiva, el personal, las transferencias y transiciones y el grado en que la comunicación es abierta. Se concluyó que aunque el personal percibía como positivo el proceso de mejoramiento y apoyo de la administración también sentía que era juzgado si reportaba algún evento adverso.

Transmission Of Intra-cellular Genetic Information: A System Proposal.

One of the great challenges of the scientific community on theories of genetic information, genetic communication and genetic coding is to determine a mathematical structure related to DNA sequences. In this paper we propose a model of an intra-cellular transmission system of genetic information similar to a model of a power and bandwidth efficient digital communication system in order to identify a mathematical structure in DNA sequences where such sequences are biologically relevant. The model of a transmission system of genetic information is concerned with the identification, reproduction and mathematical classification of the nucleotide sequence of single stranded DNA by the genetic encoder. Hence, a genetic encoder is devised where labelings and cyclic codes are established. The establishment of the algebraic structure of the corresponding codes alphabets, mappings, labelings, primitive polynomials (p(x)) and code generator polynomials (g(x)) are quite important in characterizing error-correcting codes subclasses of G-linear codes. These latter codes are useful for the identification, reproduction and mathematical classification of DNA sequences. The characterization of this model may contribute to the development of a methodology that can be applied in mutational analysis and polymorphisms, production of new drugs and genetic improvement, among other things, resulting in the reduction of time and laboratory costs.

Risk Of Leukemia In First Degree Relatives Of Patients With Nonsyndromic Cleft Lip And Palate.

The aim of this study was to determine the frequency of leukemia in parents of patients with nonsyndromic cleft lip and/or cleft palate (NSCL/P). This case-control study evaluated first-degree family members of 358 patients with NSCL/P and 1,432 subjects without craniofacial alterations or syndromes. Statistical analysis was carried out using Fisher's test. From the 358 subjects with NSCL/P, 3 first-degree parents had history of leukemia, while 2 out of 1,432 subjects from the unaffected group had a family history of leukemia. The frequency of positive family history of leukemia was not significantly increased in first-degree relatives of patients with NSCL/P.

Behaviour of oligodendrocytes and Schwann cells in an experimental model of toxic demyelination of the central nervous system

Oligodendrocytes and Schwann cells are engaged in myelin production, maintenance and repairing respectively in the central nervous system (CNS) and the peripheral nervous system (PNS). Whereas oligodendrocytes act only within the CNS, Schwann cells are able to invade the CNS in order to make new myelin sheaths around demyelinated axons. Both cells have some limitations in their activities, i.e. oligodendrocytes are post-mitotic cells and Schwann cells only get into the CNS in the absence of astrocytes. Ethidium bromide (EB) is a gliotoxic chemical that when injected locally within the CNS, induce demyelination. In the EB model of demyelination, glial cells are destroyed early after intoxication and Schwann cells are free to approach the naked central axons. In normal Wistar rats, regeneration of lost myelin sheaths can be achieved as early as thirteen days after intoxication; in Wistar rats immunosuppressed with cyclophosphamide the process is delayed and in rats administered cyclosporine it may be accelerated. Aiming the enlightening of those complex processes, all events concerning the myelinating cells in an experimental model are herein presented and discussed.

Produção de alface hidropônica em três ambientes de cultivo

It was proposed to evaluate the hydroponic lettuce production, variety Vera, on inclined benches with channels of 100 mm, and Nutrient Film Technique, as answer to carbon dioxide application and evaporative cooling. There were five cycles of cultivation from March, 20th to April, 17th (C1); from May, 25th to June, 29th (C2); from July, 13th to August, 20th (C3); from August, 27th to October, 10th (C4); from December, 12th to January, 10th (C5). In three greenhouses were tested the following systems: (A1) without evaporative cooling air CO2 aerial injection, (A2) with CO2 aerial injection and without evaporative cooling and (A3) with CO2 aerial injection and pad-fan evaporative cooling system. The fresh and dry mass of leaves in grams, number of leaves and leaf area in square millimeter were evaluated. The completely randomized statistical analysis was used. The cycle C1 were used 48 replications, for cycles C2, C3 and C5 were used 64 replications and C5 were used 24 replications. The results showed that greenhouse with evaporative cooling system and CO2 allow better development and greater lettuce yield. It was possible to conclude that the aerial injection of CO2, in the absence of evaporative cooling system, did not lead increasing the lettuce productivity to most cycles. Bigger lettuce leaf areas were found in periods with higher temperatures.